Testicular Cancer

Testicular cancer is associated with oligospermia in more than 50% of men before treatment (11,14). Several possible causes have been suggested. First, local pathological change to the testis is apparent on biopsy of the contralateral testis, with 24-60% showing significant fibrosis of the seminiferous tubules, Sertoli cell only in 8%, and carcinoma in situ in 5-8%. Local tumor effects, including elevation of scrotal temperature, alterations in testicular blood flow, and disruption of the blood-testis barrier, may also contribute. Furthermore, sperm antibodies have been found in a high proportion of

Table 1

Gonadotoxic Drugs

Table 1

Gonadotoxic Drugs

Group

Definite Gonadotoxicity

Alkylating agents

Cyclophosphamide (5)

Chlorambucil

Mustine

Melphalan

Busulfan (27)

Carmustine (68)

Lomustine (68)

Antimetabolites

Cytarabine

Vinca alkaloids

Vinblastine (69)

Others

Procarbazine

Cisplatin (70)

patients with testicular cancer (15). Finally, testicular cancer may be hormonally active, and local hormone production may impair spermatogenesis.

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